Radiation‐Induced Skin Injury in Cancer Radiotherapy: From Mechanisms to Management

ABSTRACT Radiation‐induced skin injury (RISI) represents one of the most prevalent and clinically significant complications of therapeutic ionizing radiation. It affects about 90–95% of cancer radiotherapy (RT) patients, manifesting itself as desquamation, edema, and atrophy in chronic cases. The burden of symptoms can profoundly decrease the patients’ quality of life and cause treatment termination. While few proactive prevention methods exist, notable advancements have been made in therapeutic approaches to treat RISI. This perspective article covers the current understanding of the collective skin reactions caused by radiation in cancer RT, along with the existing strategies for RISI management, and provides perception to research directions. With emphasis on acute RISI that primarily affects the epidermis, the pathophysiological effects and the mechanisms involved in underpinning RISI are explored, stressing the inflammatory cascades and reactive oxygen species overproduction. We also evaluate a number of both established and emerging strategies for the prevention and the management of RISI. Here, we recommend that further research consider shifting focus toward the development of biomaterials and drug delivery systems for preventative interventions that reduce the incidence of RISI before it becomes clinically established, and the exploration of these prophylactic strategies for both acute and chronic RISI.